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Nat Commun. 2019 Sep 2;10(1):3935. doi: 10.1038/s41467-019-11862-x.

The molecular origin and taxonomy of mucinous ovarian carcinoma.

Author information

1
Peter MacCallum Cancer Centre, Melbourne, Australia.
2
Walter and Eliza Hall Institute, Parkville, Australia.
3
The University of Melbourne, Melbourne, Australia.
4
Western Health, St. Albans, Australia.
5
University of British Columbia, Vancouver, Canada.
6
Kinghorn Cancer Centre and Garvan Institute of Medical Research, Darlinghurst, Australia.
7
Westmead Hospital, University of Sydney, Sydney, Australia.
8
Queensland Institute of Medical Research, Brisbane, Australia.
9
Royal Melbourne Hospital, Parkville, Australia.
10
Nicola Murray Centre for Ovarian Cancer Research, Cancer Research UK Edinburgh Centre, University of Edinburgh, Edinburgh, UK.
11
Hudson Institute of Medical Research, Clayton, Australia.
12
The University of New South Wales, Sydney, Australia.
13
Royal Brisbane and Womens Hospital, Brisbane, Australia.
14
Monash Medical Centre, Clayton, Australia.
15
Mayo Clinic, Rochester, MN, USA.
16
The University of Calgary, Calgary, Canada.
17
CRCHUM, Montreal, Canada.
18
Royal Womens Hospital, Parkville, Australia.
19
University of Montreal, Montreal, Canada.
20
Centre Hospitalier de L'Université de Montreal, Montreal, Canada.
21
Royal Children's Hospital, Flemington, Australia.
22
NSW Health Pathology, Sydney, Australia.
23
Monash University, Clayton, Australia.
24
Cabrini Health, Malvern, Australia.
25
Frankston Hospital, Frankston, Australia.
26
Peter MacCallum Cancer Centre, Melbourne, Australia. kylie.gorringe@petermac.org.
27
The University of Melbourne, Melbourne, Australia. kylie.gorringe@petermac.org.

Abstract

Mucinous ovarian carcinoma (MOC) is a unique subtype of ovarian cancer with an uncertain etiology, including whether it genuinely arises at the ovary or is metastatic disease from other organs. In addition, the molecular drivers of invasive progression, high-grade and metastatic disease are poorly defined. We perform genetic analysis of MOC across all histological grades, including benign and borderline mucinous ovarian tumors, and compare these to tumors from other potential extra-ovarian sites of origin. Here we show that MOC is distinct from tumors from other sites and supports a progressive model of evolution from borderline precursors to high-grade invasive MOC. Key drivers of progression identified are TP53 mutation and copy number aberrations, including a notable amplicon on 9p13. High copy number aberration burden is associated with worse prognosis in MOC. Our data conclusively demonstrate that MOC arise from benign and borderline precursors at the ovary and are not extra-ovarian metastases.

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